JOMPAC

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

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Original Article
The effects of the national vaccination program and massive migration on the epidemiology of hepatitis A in children from 2013 to 2018
Aim: Acute hepatitis A is a common public health problem in underdeveloped and developing countries. The hepatitis A vaccine was implemented as part of the National Immunization Program in Turkey in November 2012. The present study aimed to investigate the effects of the national vaccination program and massive migration on the epidemiology and clinical burden of hepatitis A infection. Material and Method: The study was a single center, retrospective chart review study among children diagnosed with viral hepatitis A infection between 0 and 18 years of age from January 2013 to February 2018 in Gaziantep Cengiz Gökçek Maternity and Children Hospital, Turkey. All cases’ age, diagnosis time, nationality, and gender information were evaluated. The length of stay, the maximum value of alanine transaminase and aspartate aminotransferase, and the direct medical cost of hospitalization were also evaluated in hospitalized cases. Results: During the study period total of 1039 cases were diagnosed with hepatitis A infection. Of these cases, 53% were males, 14% were Syrian refugees, and the median age was 7.9-year. The number of cases per year (2013 through 2017) was 321, 360, 157, 119, and 73, respectively. The majority of the cases were detected in November, December, and January. While the total number of cases was declining, we saw that the number of Syrian cases was increasing. The percentage of Syrian children in total cases in 2013 and 2017 was 6.5% and 52.1%, respectively. The hospitalization rate was %49.4, the median length of stay was four days, and the average medical cost of hospitalization was 246.8$/case. Conclusion: With the national vaccination program, prevalence is declining, but the number of susceptible individuals in society is still adversely affecting the epidemiology of the disease. Continuous monitoring of epidemiological data and efforts to expand vaccine coverage are required for infection control.


1. Jacobsen KH, Wiersma ST. Hepatitis A virus seroprevalence by age and world region, 1990 and 2005.
2. Lee DY , Chae SJ, Cho SR, Choi W , Kim CK, Han MG. Nationwide seroprevalence of hepatitis A in South Korea from 2009 to 2019.
3. Enoch A, Hardie DR, Hussey GD, Kagina BM. Hepatitis A seroprevalence in Western Cape Province, South Africa: Are we in epidemiological transition? S Afr Med J 2019; 109: 314–8.
4. Demiray T, Köroğlu M, Jacobsen KH, Özbek A, Terzi HA, Altındiş M. Hepatitis A virus epidemiology in Turkey as universal childhood vaccination begins: seroprevalence and endemicity by region. Turk J Pediatr 2016; 58: 480-91.
5. Chatziprodromidou IP, Dimitrakopoulou ME, Apostolou T, Katopodi T, Charalambous E, Vantarakis A. Hepatitis A and E in the Mediterranean: A systematic review. Travel Med Infect Dis 2022; 47: 102283.
6. Ceran N, Yüksel Kocdogan F, Mert D, et al. Hepatitis A seroprevalence in children and young adults in Istanbul, Turkey: seroprevalence change and associated factors. J Viral Hepat 2012; 19: 72–6.
7. Badur S, Öztürk S, Ozakay A, Khalaf M, Saha D, Van Damme P . A review of the experience of childhood hepatitis A vaccination in Saudi Arabia and Turkey: implications for hepatitis A control and prevention in the Middle East and North African region. Hum Vaccin Immunother 2021; 17: 3710–28.
8. Akman AÖ, Burhan BY, Uzun AK, Taş D. Türkiye’de Hepatit A aşısının uygulanmasından sonra yaşa özel seroprevalans: Tek merkezli çocuk hastanesinin sonuçları. Türk Pediatr Arşivi 2020; 55: 370-5.
9. Halicioglu O, Akman SA, Tatar B, Atesli R, Kose S. Hepatitis A seroprevalence in children and adolescents aged 1-18 years among a low socioeconomic population in Izmir, Turkey. Travel Med Infect Dis 2012; 10: 43-7.
10. Karadeniz A, Akduman Alaşehir E, Yeşilbağ Z, Balıkçı A, Yaman G. The seroprevalence of hepatitis A in Istanbul, Turkey. Marmara Med J 2017; 30: 14-7.
11. Kurugol Z, Aslan A, Turkoglu E, Koturoglu G. Changing epidemiology of hepatitis A infection in Izmir, Turkey. Vaccine 2011; 29: 6259-61.
12. Bizri AR, Fares J, Musharrafieh U. Infectious diseases in the era of refugees: Hepatitis A outbreak in Lebanon. Avicenna J Med 2018; 8: 147-52.
13. Köse Ş, Ödemiş I, Çelik D, Gireniz Tatar B, Akbulut I, Çiftdoğan DY. Hepatitis A, B, C and HIV seroprevalence among Syrian refugee children admitted to outpatient clinics. Le Infez Med 2017; 25: 339-43.
14. Michaelis K, Wenzel JJ, Stark K, Faber M. Hepatitis A virus infections and outbreaks in asylum seekers arriving to Germany, September 2015 to March 2016.
15. Mellou K, Chrisostomou A, Sideroglou T, et al. Hepatitis A among refugees, asylum seekers and migrants living in hosting facilities, Greece, April to December 2016.
16. Ekmekci PE. Syrian Refugees, Health and Migration Legislation in Turkey. J Immigr Minor Heal 2017; 19: 1434-41.
17. Doganay M, Demiraslan H. Refugees of the Syrian Civil War: impact on reemerging infections, health services, and biosecurity in Turkey. Heal Secur 2016; 14: 220–5.
18. Ergönül Ö, Tülek N, Kayı I, Irmak H, Erdem O, Dara M. Profiling infectious diseases in Turkey after the influx of 3.
19. Freidl GS, Tostmann A, Curvers M, et al. Immunity against measles, mumps, rubella, varicella, diphtheria, tetanus, polio, hepatitis A and hepatitis B among adult asylum seekers in the Netherlands, 2016.
20. Mülteciler Derneği. Türkiye’deki Suriyeli Sayısı Ağustos 2022.
21. Hofmeister MG, Yin S, Aslam MV, Teshale EH, Spradling PR. Hepatitis A Hospitalization Costs, United States, 2017.
22. Rajan E, Shattock AG, Fielding JF. Cost-effective analysis of hepatitis a prevention in Ireland. Am J Gastroenterol 2000; 95: 223-6.
Volume 3, Issue 3, 2022
Page : 211-215
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